1 Introduction Executive Team Report The purpose of this paper is to provide the Board with an overview of current key issues locally and in NHS Wales through a report from members of the Executive Team of Aneurin Bevan Health Board. Not all members of the Team have provided content for the report as updates are also provided through other reports on the Board agenda. It also provides the opportunity to bring forward items to the Health Board to demonstrate in public, areas that are being progressed and achievements that are being made, which might not come through prior consideration by Health Board Committees or go directly to the Board as key discussion papers. This report is intended to ensure the Board remains up-to-date and also provides an opportunity to highlight areas that can be brought back for future agenda. 2 Executive Team Report 2.1 Notable Achievements and Acknowledgement of Successes Primary Care Resource Centre Blaenavon open day Healthcare and Local Authority staff have had a first glimpse of their new working environment inside the 4.5m Blaenavon Primary Care Resource Centre. Staff from Carregwen GP Surgery recently joined members from the Community Health Council on a guided tour around the centre which forms part of an innovative 18 million Integrated Community Campus. 1
Completion of the building is planned for the end of September 2014 and the first patients will attend in early October. The Resource Centre will include a doctor s surgery, pharmacy, dentistry, a range of therapies, community nursing and health visiting and screening services. The Campus as a whole will be unique to the Gwent area as it will be the first fully integrated facility to be planned and developed in the Gwent area. Health services, Local Authority services including social care, Police, Leisure and Educational Services will all be provided on the Campus. University Status Launch The Health and Social Services Minister, Mark Drakeford AM, earlier this month officially launched the University status of the Health Board at the Health Board Headquarters in Caerleon. The prestigious status was granted after the Health Board had shown the range of educational and research activities taking place and the significant progress that has been made over recent years. Mark Drakeford said: I would like to congratulate everyone at Aneurin Bevan on becoming a University Health Board." This change recognises their commitment to continuous improvement and excellence, and to understanding how to provide better quality and more efficient services. I know that there is enthusiasm and expertise there and I hope that the University Health Board will seize this opportunity to make a visible commitment in showing how applied research and learning can deliver real benefits for patients and for Wales. Communications Team shortlisted for CIPR Awards The Health Board s Communications Team has been shortlisted for three prestigious Chartered Institute of Public Relations Wales for its work on the 'Be Winter Wise' Campaign and the Hepatitis C Look Back Exercise. 2
The CIPR PRide Awards is the only UK-wide awards scheme that recognises excellence in public relations and communications work across Scotland, Wales, Northern Ireland and six English regions. The ceremony will be on the 24 th October 2015. Staff receive qualifications at the University of South Wales Awards Congratulations to Alison Neville and Colleen Bright who have both obtained qualifications at the University of South Wales, Pontypridd. Alison Neville, Senior Nurse for CHC and Safeguarding, obtained an MSc in Health and Public Service Management and also received 'Best in Class' for her dissertation. Colleen Bright obtained a PhD in Business Administration. Health Board Member of staff s meeting with the Prince and the President Lara Cope one of the Health Board s physiotherapists was delighted when she had the opportunity during the NATO Summit to meet Prince Charles and Barack Obama, the President of the United States of America. Lara was invited to attend as she had recently been shortlisted for a St David s Award. Greenmeadow Practice The Health Board was notified that the contract for Greenmeadow practice would become vacant from 1 September 2014 due to the resignation of the partners. The Health Board followed the General Medical Services Vacant Practice Policy to award a new contract and worked closely with Gwent Local Medical Committee and Aneurin Bevan Community Health Council. As a result, the contract was awarded to a new partnership of three General Practitioners, with one being a partner in the previous Greenmeadow Partnership. The new partnership commenced on 1st September 2014 from the same premises and with the existing nursing and administrative staff thus ensuring continuity for patients registered at the practice. 3
Crumlin Surgery The Health Board has been notified that the current single handed General Practitioner wished to resign their contract on 30 September 2014 and as a result the practice would become vacant. The Health Board followed the General Medical Services Vacant Practice Policy to award a new contract and worked closely with Gwent Local Medical Committee and Aneurin Bevan Community Health Council. As a result the contract was awarded to Dr Farr and Partners, Newbridge Surgery. The new contract will commence on 1 October 2014 from the same premises with the existing administration and nursing staff. Newbridge Surgery As a result of being awarded the contract for Crumlin Surgery, Newbridge Surgery has asked to close their branch surgery in Newbridge. It is 0.4 miles from the main surgery in Newbridge. The Health Board has discussed the impact on patients with Aneurin Bevan Community Health Council and as a result is engaging with patients currently using the branch surgery. This application will be considered by the Health Board s Branch Surgery Closure Panel, which includes representation from Aneurin Bevan Community Health Council and Gwent Local Medical Committee. Abernant Surgery The Health Board has received an application from Abernant Surgery to close their branch surgery in Trinant. Following discussion with Aneurin Bevan Community Health Council, the Health Board is conducting a patient consultation process. This application and results of the patient consultation will be considered by the Health Board s Branch Surgery Closure Panel, which will include representation from Aneurin Bevan Community Health Council and Gwent Local Medical Committee. 4
Access to General Dental Services The Health Board has made additional investment to improve access to General Dental Services over the past two years. As a result of access difficulties remaining in the Newport area, the Board agreed to fund a new contract for 5,000 UDAs (Units of Dental Activity). This was awarded to a practice in Ringland, Newport and commenced on 1 August, 2014. The Health Board is now undertaking a full review of current demand and waiting times for dental services to identify if any further investment is required. Minor Oral Surgery The Primary Care Minor Oral Surgery Service commenced in April 2014 with two providers based in Newport and Blackwood. This service receives direct referrals from General Dental Practitioners. 231 referrals were made to this service during the first three months of the service being operational. Previously, these patients would have been referred to the maxillo-facial department at the Royal Gwent Hospital. In addition, there is a clinical review being conducted of patients currently on the waiting list and who would have been referred for minor oral surgery prior to the primary care service being in place. To date, 291 patients, currently on the waiting list, have been transferred to the new service for treatment, with an estimated 800 transferring over the coming months. All these patients being transferred from the waiting list will commence their treatment by 31 March 2015. Community Pharmacy Services Smoking cessation services have been deemed a priority by the Health Board. The Health Board has commissioned a further 16 Community Pharmacists to provide a Level 3 Smoking Cessation Enhanced Service, which will give a total of 22 Community Pharmacists providing this service across the Health Board area. The aim of the Level 3 Service is to increase the number of people stopping smoking, by providing individual advice and motivational support. 5
Optometry Services The Health Board has commissioned a Glaucoma Assessment Local Enhanced Service from six Optometry Practices, across the Health Board area, commencing on 1 September 2014. The aim of this Enhanced Service is provide assessment for people with glaucoma, who are under the care of the Ophthalmic Surgeons and have experienced delays with their follow up assessments. The results of the patients assessments are reviewed by the Ophthalmic Surgeons, who determine the patient s further care. To date, 670 patients have been referred to local Optometrists for assessments to be completed by 31 December 2014. It is anticipated that a further 800 patients will be referred as a result of a clinical review of patients on the ophthalmic waiting lists. In One Place (IOP): The IOP team are currently supporting the development of 17 possible opportunities across several health sectors including mental Health, Acquired Brain Injury and Learning Disability. Clinical teams are working closely with strategic housing colleagues from Local Authority partners refining service specifications for supported accommodation options and Housing Associations are helping us identify potential existing homes and development sites. We have been working closely with the Health Board s Estates Department to identify parts of the estate that could potentially be used for larger scale, strategic, developments. High Level meetings are taking place with Health and Housing Association partners to enable potential developments to be taken forward. The IOP team is looking to facilitate the development of an Information sharing protocol which will enable the safe sharing of records across the partnership. The IOP team is also looking to work closely with IT to explore all the options available to enable IOP to be more accessible to practitioners. 6
Community Dental Services New General Anaesthetic/sedation pathway for children in the Health Board was implemented in May. Early indications are that the numbers of dental GAs being completed on children are reduced by approximately 50%. This is inevitably placing pressure on the Community Dental Service (GDS) to provide alternative treatment for these children. The new domiciliary pathway involving new contracts for provision of domiciliary care by GDS dentists is working well. Triaging of referrals means that only the most complex cases are cared for in the CDS whilst others are seen in the General Dental Service. The General Dental Council (GDC) recently announced the concept of Direct Access to dental services provided by dental therapists and hygienists (DCPs) without first being assessed by a dentist as long as care is within the competency of the DCP. The CDS is looking at innovative ways to use our therapist workforce and is presently developing policies for: Dental therapists to carry out screening within the Designed to Smile programme; Dental therapists to assess and treat young children referred to the CDS. This will ensure best possible use of skill mix within the service. Outpatient services for orthopaedic patients: There are several developments that have been implemented that change the way we provide outpatient services for orthopaedic patients. The first is that the first fracture clinic at YYF has started this month, bringing a valuable service closer to patients. The second is the implementation of a new model of care for follow up patients after major joint surgery. This will ensure that all patients follow a consistent pathway and some of the patient reviews will be undertaken remotely accessing x-rays at specified milestones instead of having to attend a busy clinic. 7
Mental Health and Learning Disabilities Divisional Management Change Alison Lewis has left the Divisional Nurse post. The Division would like to thank her for her tireless work on the patient quality and safety agenda and wish her well in her new role within the Health Board. RCN Nurse of the Year Awards/Nursing Conference/ Research and Development Conference 6 nominations for the RCN Nurse of the Year have been made from Mental Health and Learning Disability Services. There will be 2 presentations at the Nursing Conference for the Mental Health and Learning Disability Division. There were 14 posters displayed for the Division at the recent R&D Conference. Inspiring Services Through Shared Learning The Mental Health and Learning Disabilities Division held their first showcase on the morning of 12 September in the Main Hall, St Cadoc s Hospital. This inaugural event marked the start of the multi-professional bi-annual events to enable the sharing of good practice throughout the Division. The event had 4 formal presentations and 8 round the world cafe style presentations. Vanguard The Vanguard project is now in its second month and the LEAP team have received 30 referrals to date. This includes 25 active referrals and 5 that have been discharged or not taken forward. Although it is early in its evaluation, some initial learning indicates: Apart from 1 individual who was already being seen by the CMHT, none of the referrals that the team have worked with have gone on to require longer term support from secondary mental health services and require a Care and Treatment Plan (CTP); 8
Through the discussions with the GP surgeries there have been positive outcomes in regard to a strong sense of team working has been built up between the surgeries and the team. This has been developed through having accessibility of support by the LEAP team for the surgeries. This has meant the team can respond more directly with the referrer, with face to face contact and working through a referral together being seen as a crucial not just to the speed and response of referral but also to the quality of information provided to the team. Communication and accessibility for support in both directions is seen by both the LEAP team and the surgeries as key outcomes to continue to strengthen these relationships. At the beginning of the project the team began with saying that they would only take referrals for those who they normally be referred into secondary mental health services. However, very quickly this changed and the team talked about being open to seeing anyone with a mental health issue. The team feel that by being able to respond much quicker to broader presentations means that they are stopping individuals becoming more unwell due to potential delays and stopping them from potentially requiring longer term mental health support. 3. Consultant Appointments The outcomes from the Statutory Consultant Advisory Appointments Committees since the previous meeting are as follows: Appointment of Consultant General Adult Psychiatrist The Health Board held interviews for the post of Consultant General Adult Psychiatrist on Thursday 10 th July 2014. The appointments panel comprised the following members: Representing the Chairman: Professor Siobhan McClelland, Vice Chair, Aneurin Bevan University Health Board Representing the Chief Executive: Mr Richard Bevan, Board Secretary, Corporate Services, 9
Representing Both the Medical Director and Cardiff University: Dr Hywel Jones, Consultant in Anaesthetics and Assistant Medical Director, Clinical Director: Dr Nahla Jamil, Clinical Director and Consultant Psychiatrist, Representing the Royal College: Dr Christopher Bools, Consultant in Child and Adolescent Psychiatry, Oxford Health NHS Foundation Trust Representing : Dr Chris O Connor, Divisional Director for Mental Health, 1 applicant was interviewed for this post. The recruitment and interview process was conducted in accordance with Health Board policies and procedures. The appointments panel recommended Dr Sirwan Abdul for appointment to this post. Appointment of Consultant Anaesthetist (2 posts) The Health Board held interviews for the post of Consultant Anaesthetist (2 posts) on Tuesday 22 nd July 2014 (one for Nevill Hall and one for Royal Gwent Hospital) The appointments panel comprised the following members: Representing the Chairman: Ms Wendy Bourton, Independent Board Member Third Sector, Representing the Chief Executive: Mr Alan Brace, Director of Finance, Aneurin Bevan University Health Board Representing the Medical Director: Mr Duncan Ingrams, Head & Neck Consultant and Assistant Medical Director, 10
Representing the Clinical Director: Dr Stephen Edwards, Consultant in Anaesthetics, Aneurin Bevan University Health Board Representing the Royal College: Dr Rachel Collis, Consultant in Anaesthetics, Cardiff & Vale University Health Board Representing Cardiff University: Dr Iljaz Hodzovic, Senior Lecturer, Aneurin Bevan University Health Board Representing : Dr Andy Bagwell, Clinical Director for Anaesthetics, Representing the Divisional Director Mrs Mary McKerrow, Assistant General Manager, Representing the Divisional General Manager Dr Tracey Haynes, Consultant in Anaesthetics Dr Gill Richardson attended to observe ABUHB AAC process prior to serving on a panel. 6 applicants were interviewed for this post. The recruitment and interview process was conducted in accordance with Health Board policies and procedures. All candidates were considered appointable. The appointments panel recommended Dr Graeme Lilley and Dr Non Morris for appointment to these posts. Within a week of the panel taking place, a further whole time Consultant Anaesthetist post became available at Nevill Hall Hospital, against an identical job description. The Royal College endorsed the whole panel s recommendation of the additional appointment of Dr Louise Webster. Appointment of Consultant Otorhinolaryngologist The Health Board held interviews for the post of Consultant Otorhinolaryngologist on Tuesday 26 th August 2014. The appointments panel comprised the following members: Representing the Chairman: Mr Chris Koehli, Independent Board Member, Aneurin Bevan University Health Board 11
Representing the Chief Executive: Dr Gill Richardson, Director of Public Health, Public Health Team, Representing the Medical Director: Mr Duncan Ingrams, Ear Nose and Throat Consultant and Assistant Medical Director, Aneurin Bevan University Health Board Clinical Director: Mr Mark Preece, Consultant in Ear Nose and Throat and Clinical Director, Representing the Royal College: Mr Stuart Wells, Consultant in Ear Nose and Throat, Musgrove Park Hospital Representing Cardiff University: Professor John Chester, Institute of Cancer & Genetics, Consultant Medical Oncology Representing : Dr Andy Bagwell, Consultant in Anaesthetics and Clinical Director, Representing the Divisional Director Mrs Teresa Allcock, Directorate Manager, Representing the Divisional General Manager 3 applicants were interviewed for this post. The recruitment and interview process was conducted in accordance with Health Board policies and procedures. The appointments panel recommended Dr Sarah Farmer for appointment to this post. 4 Conclusion and Recommendation: The Board is asked to receive this report for information. Report prepared and sponsored by: Executive Team September 2014 12